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Neuropsychiatrie de l''Enfance et de l''Adolescence最新文献

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Agenda 议程
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.04.001
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引用次数: 0
Description et intérêt d’un dispositif collaboratif multidisciplinaire pour améliorer les pratiques de prescriptions médicamenteuses en hôpital de jour pour adolescents 对一个多学科协作系统的描述和兴趣,以改善青少年日间医院的药物处方实践
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.02.007
A. Laporte , A. Chaupin , T. Lanot
A quantitative assessment of drug prescriptions was carried out in a day hospital for adolescents following several cases of drug iatrogenia and lack of therapeutic response to treatment. These data – which are consistent with the literature on the frequency, age of introduction and off-label prescribing in child psychiatry – prompted the unit to set up a working group in 2020 to monitor drug prescriptions, including the pharmacy and the pharmacokinetics laboratory at the hospital and university centre. The main aim of this work was to highlight the improvements in how adolescents are treated for drug-related problems, thanks to this multidisciplinary approach, in terms of the improvements proposed and the resulting clinical benefits. In practice, a meeting was organised every six months at the day hospital to discuss one or two complex situations. The doctor and nurses described the clinical context and explained the difficulties. The pharmacist carried out a drug history and an in-depth analysis of the prescription and provided information on good practice. The biologist analysed the results of plasma pharmacological assays and made recommendations. A review of the literature could also have been carried out. The doctor recorded these discussions in the patient file and involved the teenager and his or her legal representatives in the conclusions of the meeting and the resulting therapeutic choices. This decision-making aid means that a specific, collegial period of reflection can be devoted to drug prescribing, and it provides a better framework for therapeutic strategies, especially outside the scope of marketing authorization. Abnormalities in the metabolism of psychotropic drugs have been identified. This meeting can also contribute to the development of new skills. We propose to highlight how this working method helps to improve the quality, effectiveness and safety of drug prescribing.
在几例药物医源性和治疗反应不足的青少年日间医院,对药物处方进行了定量评估。这些数据与关于儿童精神病学中药物使用频率、使用年龄和标签外处方的文献一致,促使该部门在2020年成立了一个工作组来监测药物处方,包括医院和大学中心的药房和药代动力学实验室。这项工作的主要目的是强调如何改善青少年治疗药物相关问题,由于这种多学科的方法,在提出的改进和由此产生的临床效益方面。在实践中,每六个月在日间医院组织一次会议,讨论一两个复杂的情况。医生和护士描述了临床情况并解释了困难。药剂师对处方进行了用药史和深入分析,并提供了良好做法的信息。生物学家分析了血浆药理学分析的结果并提出了建议。也可以对文献进行回顾。医生将这些讨论记录在患者档案中,并让青少年和他或她的法律代表参与会议的结论和由此产生的治疗选择。这种决策辅助意味着一个特定的、合议的反思期可以用于药物处方,它为治疗策略提供了一个更好的框架,特别是在上市许可范围之外。精神药物代谢异常已被确认。这次会议还可以促进新技能的发展。我们建议强调这种工作方法如何有助于提高药物处方的质量、有效性和安全性。
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引用次数: 0
Apports des données en vie réelle à la sécurité des antipsychotiques chez l’enfant et l’adolescent 儿童和青少年抗精神病药物安全性的真实数据
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.02.002
D.A. Merino , A.O. Gérard , A. Destere , F. Askenazy , F. Montastruc , M.-D. Drici , S. Thümmler
The use of antipsychotics (APs) in child and adolescent psychiatry poses major challenges, both in terms of iatrogenesis and drug abuse. Analyzing real-world data from the international pharmacovigilance database (VigiBase®) revealed age-dependent safety profiles with increased reports of alertness disorders, seizures, and aggression in young children, while adolescents were subject to higher rates of depression, abuse, and dependence. Risperidone, aripiprazole, quetiapine, and olanzapine were the most frequently implicated antipsychotics, with olanzapine associated with catatonia and quetiapine notably linked to abuse in adolescents. Nutritional disorders related to antipsychotics were more frequently reported in children and adolescents, with risperidone showing a high disproportionality signal. Adolescents exhibited specific safety concerns, including a signal for non-alcoholic steatohepatitis associated with aripiprazole. Despite the limitations of pharmacovigilance methods, these studies help quantify adverse drug event frequencies in specific subgroups and detect emerging or rare signals. These pharmacoepidemiological analyses emphasize the importance of rigorous, ongoing benefit-risk assessment when prescribing antipsychotics in the pediatric population.
在儿童和青少年精神病学中使用抗精神病药物(APs)在医源性和药物滥用方面都提出了重大挑战。通过分析国际药物警戒数据库(VigiBase®)的真实世界数据,揭示了儿童警觉性障碍、癫痫发作和攻击行为的报告与年龄相关的安全性特征,而青少年的抑郁、滥用和依赖率更高。利培酮、阿立哌唑、喹硫平和奥氮平是最常涉及的抗精神病药物,奥氮平与紧张症有关,喹硫平与青少年滥用密切相关。与抗精神病药物相关的营养失调在儿童和青少年中更为常见,利培酮显示出高歧化信号。青少年表现出特定的安全问题,包括阿立哌唑相关的非酒精性脂肪性肝炎的信号。尽管药物警戒方法存在局限性,但这些研究有助于量化特定亚组的药物不良事件频率,并检测新出现的或罕见的信号。这些药物流行病学分析强调了在儿科人群中开抗精神病药物处方时进行严格、持续的获益-风险评估的重要性。
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引用次数: 0
Les médiations thérapeutiques et art-thérapies dans la prise en charge des mineurs non accompagnés (MNA) : Une évidence ? 无人陪伴未成年人(NMs)护理中的治疗和艺术治疗调解:证据?
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.01.007
Mathilde Fragonas , Jean-Luc Sudres

Context

In a complex global political and social context, France takes in migrants including unaccompanied minors, mainly from West Africa and Asia. The adversity they have had to face can lead to psychological distress which has an impact on their well-being and quality of life.

Objective

The aim of this article is to provide a synopsis of the psychopathological and socio-cultural difficulties that these children and adolescents may present when they arrive in France. This study focuses on indications and applications of therapeutic/art therapeutic mediations (more specifically theatre) offered to migrant populations.

Method

A literature review was carried out on the psychological support offered in an intercultural context to migrant children and adults. Searches were conducted on bibliographic databases (EBSCP, PubMed and Google Scholar) in addition to grey literature and field practices, to identify the therapeutic mediation/art therapy used. A clinical example is also presented based on clinical practices in an institution.

Results

The effects in migrant populations are recognized by the scientific community, helping to reduce symptoms of adaptive stress due to acculturation and/or post-traumatic stress, anxiety and depression, to increase existential satisfaction and the development of hope, to reduce behavioral difficulties such as hyperactivity, and to play a role in the development of emotional and social skills, self-esteem and resilience. However, few studies have focused specifically on Unaccompanied Minors, even though they present real needs. A clinical focus was placed on the relevance of dramatherapy (therapeutic mediation through theatre), with the development of a standardised and reproducible programme. However, given the extent of their needs and the effectiveness of such therapeutic options, it is very surprising that few studies have focused specifically on unaccompanied minors.

Conclusion

In view of the effectiveness of mediation and art therapy with migrant populations, it seems appropriate and necessary to offer psychological care of this type to unaccompanied minors. Given the increasing numbers of these young people arriving in France, we aim to point out the importance to design and test intervention programs using mixed research methods to assess their clinical impact and to carry out additional standardisation work with recommendations for good practice and training for practitioners.
在复杂的全球政治和社会背景下,法国接收移民,包括主要来自西非和亚洲的无人陪伴的未成年人。他们不得不面对的逆境可能导致心理困扰,从而影响他们的健康和生活质量。目的本文的目的是提供这些儿童和青少年到达法国时可能出现的精神病理和社会文化困难的概述。本研究的重点是提供给流动人口的治疗/艺术治疗药物(更具体地说是戏剧)的适应症和应用。方法对跨文化背景下对流动儿童和成人的心理支持进行文献综述。在书目数据库(EBSCP、PubMed和谷歌Scholar)以及灰色文献和实地实践中进行检索,以确定所使用的治疗调解/艺术疗法。并结合某机构的临床实践,提出了一个临床实例。结果在流动人口中的作用得到了科学界的认可,有助于减少由于文化适应和/或创伤后应激、焦虑和抑郁引起的适应性压力症状,增加存在满意度和希望的发展,减少行为困难,如多动,并在情感和社交技能、自尊和恢复力的发展中发挥作用。然而,很少有研究专门关注无人陪伴的未成年人,即使他们有真正的需求。临床重点放在戏剧疗法(通过戏剧进行治疗调解)的相关性上,并制定了标准化和可重复的方案。然而,考虑到他们的需求程度和这种治疗选择的有效性,很少有研究专门关注无人陪伴的未成年人,这是非常令人惊讶的。结论鉴于流动人口调解和艺术治疗的效果,对无人陪伴的未成年人进行此类心理护理是适当和必要的。鉴于这些年轻人抵达法国的人数不断增加,我们的目标是指出使用混合研究方法设计和测试干预计划的重要性,以评估其临床影响,并开展额外的标准化工作,为从业人员提供良好的实践和培训建议。
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引用次数: 0
Association of internet gaming disorder and psychosocial factors: Results from a longitudinal study 网络游戏障碍与心理社会因素的关联:一项纵向研究的结果
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.01.005
Constance Prieur , Olivier Phan
The prevalence of Internet Gaming is high among adolescents in France. Some adolescents develop Internet Gaming Disorder (IGD) as they neglect school, family life and social activities offline. IGD is known to interact with other mental health problems, such as social anxiety and depression. The objective of this study was to identify the trajectory of development of IGD. The Pelleas Survey, as it is a longitudinal study, allowed to identify some socio-psychological pre-existing factors to IGD with a second wave survey at six months. Students from 11 to 18 years old were surveyed at school. Prevalence of IGD was 12% in the sampling. Depression was found to be as high as 11%. We found that pre-existing depression was a risk factor for IGD. These results suggest that some adolescents try to cope with depression with IGD.
在法国青少年中,网络游戏的普及率很高。一些青少年由于忽视学校、家庭生活和线下社交活动而患上了网络游戏障碍(IGD)。众所周知,IGD与其他心理健康问题相互作用,如社交焦虑和抑郁。本研究的目的是确定IGD的发展轨迹。Pelleas调查是一项纵向研究,可以在六个月后进行第二波调查,以确定一些社会心理因素对IGD的影响。11至18岁的学生在学校接受了调查。样本中IGD患病率为12%。抑郁症的比例高达11%。我们发现,先前存在的抑郁症是患IGD的一个危险因素。这些结果表明,一些青少年试图用IGD来应对抑郁症。
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引用次数: 0
Analyse de livre 图书分析
Q4 Medicine Pub Date : 2025-05-01 DOI: 10.1016/j.neurenf.2025.02.004
P. Duverger
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引用次数: 0
Au-delà des silences : explorer le « faire fratrie » dans le contexte de la déficience intellectuelle 超越沉默:在智力缺陷的背景下探索“兄弟情谊”
Q4 Medicine Pub Date : 2025-04-05 DOI: 10.1016/j.neurenf.2025.03.003
A. Frenk-Renaud , A. Courtinat-Camps
This research examines sibling experiences within families where one child has an intellectual disability, giving a voice to all members, including the child with the disability. Unlike studies focused on parental perceptions, it directly explores the lived experiences of siblings, who are often overlooked, particularly younger ones. Through an exploratory approach, the study highlights the uniqueness of sibling dynamics and the meaning each child attributes to their relationships within the family. We initially met with four sibling groups, consisting of children aged 4 to 18, each sharing a common history with their brothers and sisters but experiencing it in a unique way. To illustrate these singular positions, we focused on one sibling group composed of four brothers and sisters, the eldest of whom — Florian — has an intellectual disability. Thematic analyses revealed ambivalent interactions marked by conflicts, violence, and moments of complicity. These relationships oscillated between solidarity and rivalry, often exacerbated by parental expectations or redistributed responsibilities. Barbara, for instance, embodied a “functional eldest” assuming a parental role due to her brother's disability. These responsibilities can foster altruistic behaviors but also mask latent suffering. Silence around the disability is a recurring theme. Children avoid discussing it, which reinforces their isolation and limits their understanding of the challenges associated with disability. Florian verbalized a feeling of exclusion, while his siblings sometimes expressed guilt or incomprehension. This research underscores the importance of recognizing children's voices, whether they have a disability or not, to understand their perceptions and support their development. It highlights the necessity of specific support systems to assist families facing disability-related challenges.
这项研究调查了家庭中有一个孩子有智力障碍的兄弟姐妹的经历,给所有成员,包括残疾的孩子一个发言权。与关注父母看法的研究不同,它直接探讨了兄弟姐妹的生活经历,而兄弟姐妹往往被忽视,尤其是年幼的兄弟姐妹。通过一种探索性的方法,该研究强调了兄弟姐妹动态的独特性,以及每个孩子在家庭关系中所赋予的意义。我们最初会见了四个兄弟姐妹小组,由4到18岁的孩子组成,每个人都与他们的兄弟姐妹分享共同的历史,但以独特的方式经历它。为了说明这些独特的位置,我们把重点放在一个由四个兄弟姐妹组成的兄弟姐妹群体上,其中最大的弗洛里安有智力障碍。专题分析揭示了以冲突、暴力和共谋时刻为特征的矛盾互动。这些关系在团结和竞争之间摇摆,往往因父母的期望或责任的重新分配而恶化。比如芭芭拉,由于她哥哥的残疾,她就扮演了一个“功能性老大”的角色。这些责任可以促进利他行为,但也掩盖了潜在的痛苦。围绕残疾的沉默是一个反复出现的主题。儿童避免讨论这个问题,这加剧了他们的孤立,限制了他们对残疾相关挑战的理解。弗洛里安用语言表达了一种被排斥的感觉,而他的兄弟姐妹有时会表达内疚或不理解。这项研究强调了认识儿童声音的重要性,无论他们是否有残疾,都能理解他们的看法并支持他们的发展。它强调需要具体的支助系统来帮助面临与残疾有关的挑战的家庭。
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引用次数: 0
Les hallucinations de l’enfant : à la limite de la dissociation et de la psychose ! 孩子的幻觉:接近分离和精神病的边缘!
Q4 Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.neurenf.2025.01.003
J. Moussaoui , B. Oneib , F. El Ghazouani
Hallucinations in children are frequently a subject of heated debate; they are common symptoms in child psychiatry consultations, which are important to define quickly. Often occurring in a context of dissociation, anxiety or post-trauma, they are often resolved without resorting to pharmacological treatment. A non-psychiatric or psychotic etiology must be ruled out because its prognosis may be guarded. We report the case of a five-year-old child presenting visual and auditory hallucinations by exposing our diagnostic approach to fuel the debate around the limit of childhood psychosis regarding hallucinations.
儿童的幻觉经常是一个激烈争论的话题;它们是儿童精神病学咨询中常见的症状,重要的是要迅速确定。通常发生在分离,焦虑或创伤后的背景下,他们往往不诉诸药物治疗就能解决。非精神或精神病因必须排除,因为其预后可能是谨慎的。我们报告了一个五岁儿童出现视觉和听觉幻觉的病例,通过暴露我们的诊断方法来引发关于儿童精神病关于幻觉的限制的辩论。
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引用次数: 0
Agenda 议程
Q4 Medicine Pub Date : 2025-02-21 DOI: 10.1016/j.neurenf.2025.02.001
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引用次数: 0
Implication des parents dans un centre de diagnostic d’autisme : étude qualitative de leur vécu 父母在自闭症诊断中心的参与:对他们生活的定性研究
Q4 Medicine Pub Date : 2025-01-31 DOI: 10.1016/j.neurenf.2024.11.009
M. Ben Amara , N. Pommepuy , A. Révah-Levy , J. Ingelaere , J. Sibeoni , P. Zylberberg

Objective

The aim of this study was to explore the parent's lived experiences of the diagnostic assessment of autism spectrum disorder within the framework of UNIDEP, an expert center with the specificity of including parents during all of the assessment sessions by means of their presence with professionals behind a one-way mirror.

Methods

We conducted a monocentric and retrospective qualitative study following the five-stage Inductive Process to analyze the Structure of lived Experience method. Data collection was through semi-structured interviews with parents who had undergone the diagnostic evaluation experience at UNIDEP and who had received an autism spectrum disorder diagnosis for their child. Data analysis was based on an individual descriptive phase and a group structuring phase with the help of NVIVO software. The recruitment of parents according to the principle of purposive sampling continued until data saturation.

Results

Ten parents were included which allowed this sample to reach data saturation. The inductive thematic analysis revealed an experience of parents structured around three axes: 1. Getting involved and being involved by professionals: active involvement of parents, quality of reception and assistance provided by professionals; 2. A shift in the parent's position and a different way of observing: being able to observe the child differently, what the assessment framework allows them to observe; and finally, 3. Being able to acquire knowledge, understanding and the ability to evolve.

Discussion

Our results suggest that the practical modalities of the diagnostic process that enhanced the feeling of parental involvement were the One-way mirror system and the permanent assistance by professionals. These modalities were integrated into a structured process that allowed parents to progressively evolve on a journey of understanding, and induced reflection about parenting and co-parenting.

Conclusion

This study allowed us to question the concrete modalities of human and material organization of our diagnostic practice in light of the richness of experiences that this framework can foster.
目的本研究的目的是在联合国发展计划署(undp)的专家中心框架内,探讨父母对自闭症谱系障碍诊断评估的生活体验,该专家中心的特点是在所有评估环节中都包括父母,通过他们与专业人员在单向镜子后的方式在场。方法采用五阶段归纳法进行单中心回顾性定性研究,分析生活体验法的结构。数据的收集是通过与在开发计划署接受过诊断评价经验的父母进行的半结构化访谈进行的,他们的孩子被诊断为自闭症谱系障碍。在NVIVO软件的帮助下,数据分析基于个体描述阶段和群体结构阶段。按照有目的抽样原则对家长进行招募,直至数据饱和。结果10名家长被纳入本样本,使本样本达到数据饱和。归纳的主题分析揭示了围绕三个轴的父母体验:1。参与和被专业人士参与:家长的积极参与,专业人士提供的接待和帮助的质量;2. 家长立场的转变和观察方式的改变能够以不同的方式观察孩子,评估框架允许他们观察到什么;最后是3。能够获得知识,理解和进化的能力。我们的研究结果表明,增强父母参与感的诊断过程的实际模式是单向镜像系统和专业人员的永久协助。这些模式被整合到一个结构化的过程中,允许父母在理解的旅程中逐步发展,并引发对养育子女和共同养育子女的反思。结论:这项研究使我们能够根据该框架可以培养的丰富经验,对诊断实践中人类和物质组织的具体模式提出质疑。
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引用次数: 0
期刊
Neuropsychiatrie de l''Enfance et de l''Adolescence
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